간행물

대한소화기학회> 대한소화기학회지

대한소화기학회지 update

The Korean Journal of Gastroenterology

  • : 대한소화기학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • :
  • : 연속간행물
  • : 월간
  • : 1598-9992
  • : 2233-6869
  • : 대한소화기병학회잡지(~1989) → 대한소화기병학회지(1990~) → 대한소화기학회지(1995~)

수록정보
77권5호(2021) |수록논문 수 : 11
간행물 제목
78권3호(2021년 09월) 수록논문
최근 권호 논문
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1간경변증 환자의 결핵성 복막염에서 Adenosine Deaminase의 역할

저자 : 김은주 ( Eunju Kim )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 3호 발행 연도 : 2021 페이지 : pp. 149-151 (3 pages)

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2식도 및 위정맥류 출혈의 진단과 치료: 2019 대한간학회 간경변증 진료 가이드라인을 중심으로

저자 : 박민경 ( Min Kyung Park ) , 이윤빈 ( Yun Bin Lee )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 3호 발행 연도 : 2021 페이지 : pp. 152-160 (9 pages)

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Varices are a frequent complication of liver cirrhosis and a major cause of mortality in patients with liver cirrhosis. Patients with decompensated cirrhosis complications have a poor prognosis and require careful management. Portal hypertension is the most common complication of liver cirrhosis, which is the key determinant for varices development. Increased intrahepatic vascular resistance to portal flow leads to the development of portal hypertension. Collateral vessels develop at the communication site between the systemic and portal circulation with the progression of portal hypertension. Varices are the representative collaterals, develop gradually with the progression of portal hypertension and may eventually rupture. Variceal bleeding is a major consequence of portal hypertension and causes the death of cirrhotic patients. The present paper reviews the latest knowledge regarding the diagnosis and management of esophageal and gastric variceal bleeding. (Korean J Gastroenterol 2021;78:152-160)

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3Early Cardiac Dysfunction in Biopsy-proven Nonalcoholic Fatty Liver Disease

저자 : Peter C. Johnson , Anthony A. Cochet , Rosco S. Gore , Stephen A. Harrison , John P. Magulick , James K. Aden , Angelo H. Paredes

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 3호 발행 연도 : 2021 페이지 : pp. 161-167 (7 pages)

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Background/Aims: Nonalcoholic fatty liver disease (NAFLD) encompasses a range of diseases from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH) and has been linked to cardiovascular disease and sub-clinical cardiac remodeling. This paper presents a retrospective study of biopsy-proven NAFL and NASH to examine the differences in subclinical cardiac remodeling.
Methods: Patients were recruited from an institutional repository of patients with liver-biopsy-confirmed NAFLD. Patients with a transthoracic echocardiogram (TTE) within 12 months of the liver biopsy were included. The parameters of the diastolic dysfunction were reviewed for the differences between NAFL and NASH as well as between the stages and grades of NASH.
Results: Thirty-three patients were included in the study, 17 with NAFL and 16 with NASH. The NASH patients were more likely to have lower platelets, higher AST, higher ALT, and higher rates of type 2 diabetes mellitus, coronary artery disease, and hypertension than the NAFL patients. The E/e' ratio on transthoracic echocardiogram was significantly higher in NASH compared to NAFL, advanced-stage NASH compared to early stage, and high-grade NASH compared to low-grade. The E/e' ratio was also significantly higher in NASH than NAFL in patients without diabetes mellitus. The presence of diastolic dysfunction trended toward significance. The other markers of diastolic dysfunction were similar. Logistic regression revealed a statistical association with E/e' and NASH.
Conclusions: NASH patients had evidence of a higher E/e' ratio than NAFL, and there was a trend towards a significant diastolic dysfunction. Patients with NASH compared to NAFL should be closely monitored for signs and symptoms of cardiac dysfunction. (Korean J Gastroenterol 2021;78:161-167)

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4Reappraisal of the Role of Ascitic Fluid Adenosine Deaminase for the Diagnosis of Peritoneal Tuberculosis in Cirrhosis

저자 : Amol Sonyabapu Dahale , Amarender Singh Puri , Sanjeev Sachdeva , Anil K Agarwal , Ajay Kumar , Ashok Dalal , Pritul D Saxena

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 3호 발행 연도 : 2021 페이지 : pp. 168-176 (9 pages)

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Background/Aims: Although peritoneal tuberculosis (TB) is one of the important differential diagnoses among cirrhotic patients with ascites, a peritoneal biopsy is not always available. High ascitic fluid adenosine deaminase (ADA) has been indicative of peritoneal TB. On the other hand, studies to assess its diagnostic utility based on the confirmation of peritoneal biopsy in cirrhotic patients are scarce.
Methods: Patients with new-onset ascites were enrolled prospectively from a tertiary hospital. Peritoneal biopsy was applied according to clinical judgment when required. Based on pathology diagnosis of the peritoneum, the diagnostic efficacy of ascitic fluid ADA for peritoneal TB was evaluated in total and cirrhotic patients, respectively.
Results: Among 286 patients enrolled, 78 were diagnosed with peritoneal TB. One hundred and thirty-two patients had cirrhosis, and 30 of those were diagnosed with peritoneal TB. The mean ADA was 72.2 U/L and 22.7 U/L in the peritoneal and non-peritoneal TB group, respectively, among the total study population, and 64.0 U/L and 19.1 U/L in the peritoneal and non-peritoneal TB group, respectively, among the subgroup with cirrhosis. The area under the curve for ADA to diagnose peritoneal TB was 0.96 in the total study population with a cutoff value of 41.1 U/L, and 0.93 in cirrhotic patients with a cutoff value of 39.9 U/L.
Conclusions: The ascitic fluid ADA measurements showed high diagnostic performance for peritoneal tuberculosis in patients with ascites regardless of cirrhosis at a similar cutoff value. (Korean J Gastroenterol 2021;78:168-176)

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5급격한 간기능 저하를 보인 급성 문맥혈전증이 동반된 간경변증 환자의 항응고제 사용 효과

저자 : 조훈길 ( Hoon Gil Jo ) , 김유리 ( Youe Ree Kim ) , 조은영 ( Eun Young Cho )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 3호 발행 연도 : 2021 페이지 : pp. 177-182 (6 pages)

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The treatment of portal vein thrombosis (PVT) in patients with liver cirrhosis (LC) has been controversial, and it is generally caseand institution-dependent. The occurrence of acute or extensive PVT is critical and requires urgent treatment because it is usually accompanied by symptoms, particularly when total occlusion occurs, causing acute decompensation of liver disease. Even in severe cases, drug selection and treatment duration are determined based on each institution's experience. Therefore, consistent guidelines for the treatment of patients with LC with PVT are required. Recently, a patient with acute occlusive PVT with LC who showed signs of acute decompensation was treated by administering low molecular weight heparin as anticoagulant therapy. After anticoagulant treatment, the portal vein was almost completely recanalized, and the deteriorated liver function improved. In addition, the patient recovered well and showed no recurrence of PVT for more than a year. Thus, the most recent knowledge regarding the treatment of nonmalignant PVT in LC was reviewed along with a case report. (Korean J Gastroenterol 2021;78:177-182)

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6성인에서 부비장 경색으로 인해 발생한 급성 복통 1예

저자 : 왕호영 ( Hoyoung Wang ) , 소훈섭 ( Hoonsub So ) , 나양원 ( Yang Won Nah ) , 김미성 ( Misung Kim ) , 이태영 ( Tae Young Lee ) , 서민정 ( Minjung Seo ) , 방성조 ( Sung-Jo Bang )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 3호 발행 연도 : 2021 페이지 : pp. 183-187 (5 pages)

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Accessory spleens are common congenital anatomic variations that are usually asymptomatic. On the other hand, they can be clinically significant if complicated by hemorrhage, torsion, or infarction. This paper describes a case of an infarcted accessory spleen in a 30-year-old male who presented with abdominal pain. Abdominal CT and MRI revealed an isolated mass, 4.5 cm in size, in the perisplenic area. An infarcted accessory spleen was suspected. The patient underwent laparoscopic accessory splenectomy. Histopathology identified the mass as splenic tissue that had undergone ischemic necrosis. A definitive diagnosis of an infarcted accessory spleen was made, and the patient was discharged on day 5 after surgery symptom-free. (Korean J Gastroenterol 2021;78:183-187)

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7Epstein-Barr Virus-associated Mixed Lymphoepithelioma-like Carcinoma and Adenocarcinoma of the Gall Bladder: An Unusual Entity

저자 : Niharika Jain , Surbhi Goyal , Puja Sakhuja , Sundeep Saluja

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 3호 발행 연도 : 2021 페이지 : pp. 188-194 (7 pages)

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Schmincke described lymphoepithelioma as an undifferentiated carcinoma with abundant lymphoid stroma in the nasopharynx. Tumors with a similar histomorphology in extrapharyngeal areas have been referred to as lymphoepithelioma-like carcinoma (LELC). The association of an Ebstein-Barr virus (EBV) infection with lymphoepithelioma is well established in the nasopharynx but not so well at the extrapharyngeal sites. Only four cases of LELC have been reported in the gall bladder, of which all were negative for the EBV. This paper reports the first case of an EBV-associated mixed gall bladder carcinoma exhibiting a distinct phenotype of LELC and adenocarcinoma with mucinous differentiation. The EBV was confirmed by the strong granular membranous and cytoplasmic expression of LMP-1 (latent membrane protein-1) on immunohistochemistry and nuclear EBER RNA on chromogen in-situ hybridization in the tumor. This is the first case of LELC positive for EBV in the gall bladder. LELC has a more favorable prognosis than conventional adenocarcinoma or squamous cell carcinoma, irrespective of the site. Although a higher T stage and nodal metastasis were exceptional in the present case in contrast to the previous cases, the EBV-associated lymphocytic response might limit the disease spread and confer better overall survival and prognosis in these patients. Nevertheless, more prospective studies with a larger cohort will be needed to understand the pathogenesis, biological behavior, and prognosis of this rare entity. (Korean J Gastroenterol 2021;78:188-194)

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8이형성을 동반한 식도 편평태선

저자 : 정해민 ( Hae Min Jeong ) , 방창석 ( Chang Seok Bang )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 3호 발행 연도 : 2021 페이지 : pp. 195-198 (4 pages)

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9식도이완불능증 치료 후 발생하는 역류 연관 증상의 발생기전

저자 : 임성균 ( Sung Kyun Yim )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 3호 발행 연도 : 2021 페이지 : pp. 199-201 (3 pages)

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식도이완불능증은 상대적으로 드문 식도 질환으로서 하부식도괄약근의 이완장애와 연동운동 소실을 특징으로 한다. 식도이완불능증의 치료는 주로 적절히 이완되지 않는 하부식도괄약근을 손상시켜 식도위접합부를 약화하는 것을 목표로 한다. 따라서 치료 후에 역류 연관 증상이 나타날 수 있으며 시행한 치료 방법 및 연구에 따라 적게는 5% 정도에서 60%까지 보고되고 있다. 다만 이러한 환자들에서 역류 연관 증상, pH monitoring 결과 그리고 식도염의 정도는 잘 일치하지 않는 것으로 보고되고 있으며, 역류 증상이 실제역류로 인해 발생하는지 여부도 불명확하다. 또한 식도이완불능증의 치료 후 발생하는 역류 연관 증상은 위식도역류로 인한 것으로 보고 양성자펌프억제제(proton pump inhibitor, PPI)를 투여하는 경우가 많으나 효과 여부가 불확실하다. 결국 이러한 문제점은 식도이완불능증의 치료 후 발생하는 역류질환에 대한 기본적인 발생기전이 명확하게 해석되어 있지 않아 기인하는 것으로 생각할 수 있다.
이에 Ponds 등3은 이러한 환자들에서 식도기능, 산 노출정도, 산성화 패턴, 증상인지정도 및 식도염 정도를 분석해 발생기전을 명확히 하고자 하였다. 식도이완불능증 치료를 받은 후 6개월 이상 경과한 18세 이상의 외래 내원객들을 대상으로 총 40명이 포함되었다. 대상자들은 각각 Gastro-Esophageal Reflux Disease Questionnaire (GERDQ)를 통해 역류 증상정도를 파악하여 역류 증상이 있는 군(RS+, GERDQ ≥8, n=20)과 역류 증상이 없는 군(RS-, GERDQ <8, n=20)에 배정되었다. 대상자들이 받은 식도이완불능증 치료의 종류는 내시경적풍선확장술(endoscopic pneumodilation), laparoscopic Heller's myotomy with Dor fundoplication, 경구내시경근절개술(peroral endoscopic myotomy, POEM)이었다. 이후 대상자들은 endo functional luminal imaging probe (EndoFLIP)를 이용하여 식도위경계부의 확장성과 식도 확장에 대한 인지 정도를 측정하고 고해상도 식도내압 검사(high-resolution manometry, HRM), acid perfusion test 그리고 prolonged combined HRM과 pH-impedance monitoring을 시행하였다. 이후 24시간 pH-impedance monitoring을 시행하고 다음날 바륨 식도조영술과 내시경을 시행하여 식도염 정도를 확인하였다. 연구 결과 RS+와 RS-는 24시간 pH-impedance상 총 acid exposure time에 큰 차이를 보이지 않았다. 그러나 acid fermentation (RS+, mean 6.6% [95% CI 2.96% to 10.2%] vs. RS-, 1.8% [95% CI -0.45% to 4.1%, p=0.03])과 acid reflux with delayed clearance (RS+, 6% [95% CI 0.94% to 11%] vs. RS-, 3.4% [95% CI -0.34% to 7.18%], p=0.051)는 RS+에서 높게 나타났다. 모든 RS+, RS- 대상자들에서 Symptom Index가 낮게 나와(<50%) 양 군 모두 역류증상이 산 자체와는 크게 연관성이 없는 모습을 보였다. 또한 RS+에서 RS-에 비해 산에 대해 매우 민감하게 반응하는 양상을 보였다. Heartburn 증상을 인지할 때까지의 시간이 더 짧았으며(RS+, 4 [2-6] vs. RS-, 30 [14-30] min, p<0.001) 더 심하게 증상을 느꼈다(RS+, 7 [4.8-9] vs. RS-, 0.5 [0-4.5] Visual Analogue Scale, p<0.001). 추가적으로 기계적 자극에 대해서도 더 민감하게 반응하였고(RS+, median 50 [38-70] mL vs. RS-, 70 [50-70] mL, p=0.03) 증상 인지 정도도 심하였다(RS+, median VAS 3 [1.1-7.4] vs. RS-, VAS 0 [0-2.8], p=0.03). 이외에 prolonged combined HRM과 pH-impedance monitoring, 내시경 상 관찰되는 식도염의 정도, HRM, 바륨 식도조영술 그리고 EndoFLIP 상 식도위경계부의 확장성 등은 큰 차이가 나지 않았다.
따라서 저자들은 치료받은 식도이완불능증 환자들에서 발생하는 역류 증상은 위식도역류에 의한 산의 역류 자체와는 관계 있는 경우가 더 적고, 산이나 기계적 자극에 대한 과민성이 많은 역할을 하는 것으로 결론지었다.

KCI등재

10COVID-19 유행 시기의 성인 염증성 장질환 임상 진료지침: 전문가 합의 권고문

저자 : 박용은 ( Yong Eun Park ) , 이유진 ( Yoo Jin Lee ) , 장지영 ( Ji Young Chang ) , 송현주 ( Hyun Joo Song ) , 김덕환 ( Duk Hwan Kim ) , 양영주 ( Young Joo Yang ) , 김병창 ( Byung Chang Kim ) , 이재곤 ( Jae Gon Lee ) , 양희찬 ( Hee Chan Yang ) , 최미영 ( Miyoung Choi ) , 김성은 ( Seong-eun Ki

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 3호 발행 연도 : 2021 페이지 : pp. 202-203 (2 pages)

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1소화기내과 전임의 수련에 대한 COVID-19의 영향

저자 : 신현필 ( Hyun Phil Shin ) , 차재명 ( Jae Myung Cha ) , 김범경 ( Beom Kyung Kim ) , 명대성 ( Dae-seong Myung ) , 문성훈 ( Sung-hoon Moon ) , 송명준 ( Myeong Jun Song ) , 윤승배 ( Seung Bae Yoon ) , 유인경 ( In Kyung Yoo ) , 이정훈 ( Jeong Hoon Lee ) , 전백규 ( Baek Gyu Jun ) , 현종진 ( Jon

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 205-213 (9 pages)

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목적: COVID-19 유행은 다양한 사회 문화적 변화를 야기하였지만, 소화기내과 전임의 교육에 대한 영향에 대한 연구는 거의 없었다. 이번 연구에서는 소화기내과 전임의 수련에 대한 COVID-19의 영향에 대해 조사하였다.
대상 및 방법: 2021년 2월 15일부터 3월 15일까지 국내 소화기내과 전임의들에게 온라인 기반 설문조사를 발송하였다. 설문은 소화기내과 전임의의 특성, COVID-19의 유행에 대한 인식도, COVID-19과 비대면 진료의 소화기내과 전임의 교육에 대한 영향에 대한 내용으로 구성되었다.
결과: 111건의 설문 결과들 중 94건의 설문 응답을 분석하였다. 소화기내과 전임의들은 COVID-19 유행에 대해 충분한 정보를 제공받고 있었으며(74.7%), 개인보호장구 착용에 대해 잘 교육받고 있었고, 충분히 제공받고 있었다(각각 74.7% 및 83.9%). 하지만, 외래 진료 스케줄과 환자 수는 각각 25.5%와 37.8%의 응답자들이 감소하였다고 응답하였고, 소화기 내시경 검사 세션과 환자 수도 각각 51.1%와 65.6%의 응답자들이 감소하였다고 응답하였다. 그 결과, 응답자들의 78.9%는 COVID-19의 유행으로 교육에 부정적인 영향을 받았다고 답변하였다. COVID-19 유행 동안에 도입된 비대면 진료가 각각 환자와 의사 측면에서 긍정적인 면이 있다고 답변한 응답자들은 불과 20.0%와 10.6%에 불과하였다. 게다가, 응답자들의 25.9%만이 수가가 적절하게 보상되더라도 비대면 진료를 이용하겠다고 응답하였으며, 68.2%의 응답자들은 비대면 진료가 교육에 부정적인 영향이 있다고 응답하였다.
결론: COVID-19 유행은 외래 진료 감소, 소화기 내시경 검사 감소, 온라인 컨퍼런스, 비대면 진료 도입을 통해 국내 소화기내과 전임의들의 교육에 부정적인 영향이 있었다. COVID-19와 같은 감염병 유행 시에 소화기내과 전임의 교육에 대한 대책 마련이 필요하다.

KCI등재

2전임의 교육 및 수련을 위한 수련기관과 학회의 역할

저자 : 이정훈 ( Jeong Hoon Lee )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 214-216 (3 pages)

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The training and education of GI fellows are crucial issues for the training institutions and academic societies. Current circumstances about GI fellows are changing rapidly according to shortage of training period of the internal medicine residency program and growing up of multimedia and web-based education system. Recently, the education board of Korean Society of Gastroenterology revised the educational objectives considering 2 years program of GI fellows. We also need to develop a concrete education program through cooperation with related organizations including the training institutions and academic societies. All of these efforts should be made with the goal of making a good gastroenterologist, not just making an endoscopist. (Korean J Gastroenterol 2021;77:214-216)

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3복부초음파 교육 지도전문의를 위한 교육수련 가이드라인 제언

저자 : 김문영 ( Moon Young Kim )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 217-219 (3 pages)

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In order to revitalize and improve the system of abdominal ultrasonography training specialists, expansion of the internal medicine ultrasonography examination at the training institution must precede. Through this, a cycle of re-education of existing ultrasonography training specialists and the improvement of ability, training new ultrasonography training specialists will be established. Education goals and processes should be aligned to ensure quality it requires the will of institutions and educators to support. With one prerequisite, retraining and re-education of existing ultrasonography training specialists and establishment of management guidelines to improve quality, and ultrasonography education I look forward to becoming the basis for taking a place little by little. (Korean J Gastroenterol 2021;77:217-219)

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4소아기 발병성 염증성 장질환 치료는 성인과 어떤 차이가 있는가?

저자 : 최소윤 ( Soyoon Choi ) , 문원 ( Won Moon )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 220-226 (7 pages)

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Pediatric-onset inflammatory bowel disease differs from adults in its epidemiological and clinical characteristics and courses. Since it is diagnosed at a young age, the duration of the disease is relatively longer than in adults. Therefore, it is necessary to select drugs in consideration of long-term risks and benefits, and efforts such as therapeutic drug monitoring to maximize the treatment effects and minimize side effects are required. In addition, special considerations for treating pediatric-onset inflammatory bowel disease include attention to the effects of the disease on growth and development, nutrition, and psychosocial problems. In children, more aggressive treatment is needed to avoid missing therapeutic window of opportunity during periods of rapid growth and development. Finally, efforts should be made to ensure that the therapeutic goals of mucosal healing are achieved, the quality of life is restored, and the transition to adult therapy is well carried out. (Korean J Gastroenterol 2021;77:220-226)

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5염증성 장질환 진료에 있어서 소아청소년에서 성인으로의 성공적인 전환은 어떻게 할 수 있는가?

저자 : 김미진 ( Mi Jin Kim ) , 홍성노 ( Sung Noh Hong ) , 김영호 ( Young-ho Kim ) , 최연호 ( Yon Ho Choe )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 227-230 (4 pages)

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With the increasing incidence of pediatric inflammatory bowel disease (IBD) in children and its impact throughout life, transition care has become an important issue. In Korea, no guidelines have been proposed to support the transition from the pediatric clinic to the adult IBD clinic. This paper reviews the current issues related to IBD patient care during the transition from pediatrics to adults to identify the barriers and critical elements for a successful transition. Thus far, a multi-disciplinary pediatric/adult clinic or alternate visits between pediatric and adult health care providers is the best model for pediatric to adult IBD clinics. Self-reliance and independence of patients with pediatric IBD are also essential for a successful transition. In addition, the timing of the transition from a pediatric clinic to an adult IBD clinic should not be determined because the issue is not the chronological age but rather the individual maturity. (Korean J Gastroenterol 2021;77:227-230)

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6고령에서 염증성 장질환의 치료 - 무엇이 다르고 무엇을 알아야 하는가?

저자 : 나수영 ( Soo-young Na )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 231-240 (10 pages)

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As the incidence of inflammatory bowel disease (IBD) are increasing with an ageing population, the incidence and prevalence of IBD in the elderly continue to increase. Older IBD patients can be classified into two groups; elderly-onset IBD patients and elderly IBD patients who were diagnosed at a young age and transitioning into advanced age. Clinicians must consider elderly-onset specific phenotypes or prognosis and age-related concerns in the treatment of elderly IBD patients. There is a paucity of evidence whether there is a different disease process when IBD occurs in older age yet. Clinicians may expect similar therapeutic effects in older and younger patients in drug selection, but since older patients are often excluded from clinical trials, evidence to support this assumption is currently lacking. Also, the risk of side effects may be higher in elderly patients. Therefore, when making management decisions in the elderly, clinicians should assess an individual's frailty rather than only considering an individual's chronological and biological age. Knowing specific requirements for managing older IBD patients may help to make an appropriate therapeutic strategy for this patient group. (Korean J Gastroenterol 2021;77:231-240)

KCI등재

7성별에 따라 염증성 장질환의 치료적 접근은 어떻게 달라져야 하는가?

저자 : 김성은 ( Seong-eun Kim )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 241-247 (7 pages)

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Although not as prominent, there are gender/sex differences in incidence/prevalence, clinical manifestation and disease course, comorbidities, therapeutic response, and patients coping strategy to the disease of inflammatory bowel disease (IBD). In this review, current knowledge about gender-specific differences in IBD would be provided and how to apply this in clinical practice be discussed. (Korean J Gastroenterol 2021;77:241-247)

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8MPV17 관련 간뇌 사립체 DNA 고갈 증후군

저자 : 홍기택 ( Ki Teak Hong ) , 임병찬 ( Byung Chan Lim ) , 문진수 ( Jin Soo Moon ) , 고재성 ( Jae Sung Ko )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 248-252 (5 pages)

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Mitochondrial DNA (mtDNA) depletion syndrome comprises diseases resulting from a deficiency of proteins involved in mtDNA synthesis. MPV17 is a mitochondrial membrane protein whose mutation causes mitochondrial deoxynucleotide insufficiency. MPV17-related hepatocerebral mtDNA depletion syndrome is a rare autosomal recessive disease. This case report describes the clinical manifestations of MPV17-related hepatocerebral mtDNA depletion syndrome analyzed by performing whole-exome sequencing (WES). A 17-month-old girl presented with developmental delay, jaundice, and failure to thrive. The laboratory findings revealed cholestatic hepatitis, increased lactate-to-pyruvate ratio, and prolongation of the prothrombin time. She developed a hypoglycemic seizure. Brain magnetic resonance imaging revealed extensive demyelination of the white matter. WES detected the p.Leu151fs and p.Pro98Leu variants in MPV17. Her parents and sibling were found to be MPV17 heterozygous carriers. She was administered supportive treatment, such as replacement of fat-soluble vitamins and cornstarch to prevent further hypoglycemic events. The patient is currently being considered for liver transplantation. Overall, WES can help diagnose hepatocerebral mtDNA depletion syndrome in patients with hepatopathy, developmental delay, lactic acidosis, and hypomyelination based on brain magnetic resonance imaging. (Korean J Gastroenterol 2021;77:248-252)

KCI등재

9총담관결석증 환자에서 침형절개도 누공형성술 후 유도선을 이용한 담도 삽관 과정 중 발생한 간문맥 내 삽관 1예

저자 : 이원동 ( Won Dong Lee ) , 송재선 ( Jae Sun Song ) , 김병선 ( Byung Sun Kim ) , 양민아 ( Min A Yang ) , 이영재 ( Young Jae Lee ) , 정금모 ( Gum Mo Jung ) , 조용근 ( Yong Keun Cho ) , 조진웅 ( Jin Woong Cho ) , 김지웅 ( Ji Woong Kim )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 253-257 (5 pages)

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Cannulation of the portal vein is a rare complication of ERCP. This paper reports a case of portal vein catheterization during ERCP in a patient with choledocholithiasis. A 62-year-old man was admitted to the Presbyterian Medical Center with right upper quadrant pain and jaundice. ERCP was performed under the suspicion of obstructive jaundice caused by a radiolucent stone. Bile duct cannulation using a pull-type papillotome was attempted, but it failed. After needle-knife fistulotomy, wire-guided cannulation was performed successfully, and 10 mL contrast was injected. On the other hand, the fluoroscopy image showed that the contrast medium disappeared very quickly. Pure blood was collected when the catheter was aspirated to identify the bile reflux, indicating possible cannulation of the portal vein. The procedure was terminated immediately and abdominal computed tomography showed air in the portal vein. One day after, a follow-up CT scan showed no air in the portal vein. The patient underwent repeated ERCP, and the common bile duct was cannulated. In most cases, isolated portal vein cannulation does not result in severe morbidity. However, it is important to aware of this rare complication so that no further invasive procedure is performed on the patient. (Korean J Gastroenterol 2021;77:253-257)

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10증상을 동반한 식도 평활근종

저자 : 최윤진 ( Yoon Jin Choi ) , 박성용 ( Sung Yong Park )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 258-260 (3 pages)

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